Cross Creek Family Dental

Primary specialty

DentistTaxonomy code 122300000X

License

30.016564 Issued in OH

Legal business name

CROSS CREEK FAMILY DENTAL

Practice address

3915 Center Rd
Brunswick, OH 44212-3087

Phone

(330) 237-1544

NPI assigned

Apr 18, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Igor J. Skalsky, DDSNPI 1174680102

Title

Ceo/Owner

Phone

(330) 273-1544

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cross Creek Family Dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Igor Joseph Skalsky, DDS

  • General Practice Dentistry
  • Brunswick, OH
  • NPI 1174680102
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1194179036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 CENTER RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442123087",
            "telephone_number": "330-237-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CENTER RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442123087",
            "telephone_number": "330-237-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSS CREEK FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "SKALSKY",
        "authorized_official_first_name": "IGOR",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "330-273-1544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.016564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE   30.016564",
            "identifier": "30.016564",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cross Creek Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shana K Connelly, MASTERS SLP
• Maya L Cortes, LSW, LCDCIII
• Susan Cossel
• Rebecca Coughlin, COTA
• Jeffrey M Creed, P.T.
• Jeffrey G Cypher, DC
• Denise Ann Czech Dydo
• Judith Ann David, PT
• Lisa A Davies, LPN
• Christopher Allen Davis

• Dentist in Brunswick, OH
• Providers in Brunswick, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.